Individual provider Active NPI

Kyle A Rasikas, M.D.

  • Hospitalist Physician
  • Grand Rapids, MI
National Provider Identifier
1114034162
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
4301041661 Issued in MI
Practice address
200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone
(616) 685-5000
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301041661 MI
Hospitalist Physician 208M00000X 4301041661 MI Primary

Addresses

Primary practice location

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502

Mailing address

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (616) 685-1800

Other identifiers 3

IdentifierTypeStateIssuer
4260170MedicaidMI
38-2145264OtherIRS TAX ID# THRU CORP
1104100571OtherMIBCBS OF MICHIGAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krasikas28641@direct.trinity-health.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090904000422 MI Practitioner - HospitalistPractitioner - Internal Medicine 4082515366 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Wayne State University School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (616) 685-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners Internal Medicine CurrentSince Mar 1, 2014 Accepting new patients
Advantage Health/Saint Mary'S Medical Group Current Accepting new patients
Spectrum Health Primary Care Partners Internal Medicine CurrentSince Mar 1, 2014 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Jul 1, 2015 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Jul 1, 2015 Accepting new patients
Spectrum Health Primary Care Partners Internal Medicine Current Accepting new patients

Locations

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

1300 Michigan St NE
Ste 103
Grand Rapids, MI 49503
Phone (616) 459-8338

4085 Burton St SE
Ste 200
Grand Rapids, MI 49546

1900 Wealthy St SE
Ste 150
Grand Rapids, MI 49506
Phone (616) 459-3158

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

1000 East Paris Ave SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 459-3158

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

602 Michigan Ave
Holland, MI 49423
Phone (616) 394-3350

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

1900 44th St SE
Kentwood, MI 49508
Phone (616) 685-8500

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Interoperability endpoints

  • Direct secure messaging: krasikas28641@direct.trinity-health.org
  • Direct secure messaging: kylerasikas@gvmsplc.allscriptsdirect.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1114034162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502",
            "telephone_number": "616-685-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502",
            "telephone_number": "616-685-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASIKAS",
        "first_name": "KYLE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301041661",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301041661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4260170",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS TAX ID# THRU CORP",
            "identifier": "38-2145264",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "1104100571",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krasikas28641@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "Mercy Health St, Mary's",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "200 Jefferson Ave SE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495034502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.